Lotus Community Care Service

Updated 6 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was conducted by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in 2 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since we our last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

Inspection activity started on 5 July 2023 and ended on 26 July 2022. We visited the location's office on 7 July and one of the provider’s supported living services on 7 July 2023. We then visited the other supported living service on 19 July 2023. We spoke with 1 person who used the service but did not receive personal care, 2 members of staff and the registered manager. We also spoke with 3 relatives of people who used the service and 1 professional who had worked with the service recently. We viewed a range of records relating to people's care and the management of the service. This included 2 people’s care and risk management plans and care records. We saw 3 staff files in relation to recruitment, training and supervision. We viewed a variety of records relating to the management of the service, including meeting records and procedures.

Updated 6 October 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Lotus Community Care Service provides supported living services to people with a learning disability or autism and people with mental health needs. At the time of our inspection the provider operated 2 of these services in the London Borough of Ealing. Staff provided 24-hour support in each service. One was a house where 4 people lived, the other was a house where up to 5 people lived. There were 3 people living there at the time of our inspection. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. Only 4 adults were receiving personal care at the time of our inspection.

People’s experience of using this service and what we found

Right Support

The use of surveillance in people’s homes had not been arranged according to relevant codes of practice and legislation. People were supported to have choice and control in their lives and staff supported them to promote this. However, the policies and systems in the service did not always support this practice as it was not always clear how people's mental capacity was assessed and decisions were taken in their best interests.

The provider had not always implemented appropriate recruitment procedures to ensure only suitable staff were recruited to work at the service.

People received care and support that met their needs. Staff supported people with their medicines safely. The service gave people care and support in a safe, clean, and maintained environments that met their needs. People were able to personalise their rooms.

Right Culture

The provider's monitoring processes were not always effective in helping to ensure people consistently received good quality care and support that always promoted people’s rights.

People and those important to them, including advocates, were involved in planning their care. People received consistent care from staff with whom they could develop relationships of trust.

The provider ensured staff had supervision and support to help them in their roles.

Right Care

The service had enough staff to keep people safe.

Staff had training on how to recognise and report abuse and they knew how to apply it. Staff attended training and completed an induction to help them support people.

The service worked with other agencies to support people to experience a smooth transition to the service. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that promoted their independence and daily living.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 7 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 21 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, recruitment, care planning and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lotus Community Care Service on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to recruitment, to supporting people in line with the principles of the Mental Capacity Act 2005, promoting people’s rights and good governance at this inspection. We have made a recommendation about person-centred support planning.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.